Clinical characteristics and prognosis of magnetic resonance-guided laser interstitial thermal therapy for brain metastases

doi:10.3969/j.issn.1672-6731.2026.08.013

Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2026, Vol. 26 ›› Issue (8): 896-902. doi: 10.3969/j.issn.1672-6731.2026.08.013

• Clinical Study • Previous Articles Next Articles

Clinical characteristics and prognosis of magnetic resonance-guided laser interstitial thermal therapy for brain metastases

Zhan XUE¹, Xiu-dong GUAN¹, Yu-fei GAO², Jin-nan ZHANG², Dong-ming YAN³, Yu-chen JI³, Jin-song WU⁴, Feng-ping ZHU⁴, Nu ZHANG⁵, Ke-jun HE⁶, De-zhi KANG⁷, Zan-yi WU⁷, Wang JIA¹^,*()

1. Department of Neurosurgical Center, Beijing Tiantan Hospital, Capital Medial University, Beijing 100070, China
2. Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin, China
3. Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, He'nan, China
4. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
5. Department of Neurosurgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, Guangdong, China
6. Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
7. Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China

Received:2026-03-23 Online:2026-08-25 Published:2026-08-27
Contact: Wang JIA
Supported by:
National Key Research and Development Program of China(2022YFC2405300); National Key Research and Development Program of China(2022YFC2405301); Beijing Natural Science Foundation - Daxing Innovation Joint Fund(L246050); Beijing Natural Science Foundation - Daxing Innovation Joint Fund(L256057)

脑转移瘤磁共振引导下激光间质热疗临床特点与预后研究

薛湛¹, 管修东¹, 高宇飞², 张金男², 闫东明³, 季玉陈³, 吴劲松⁴, 朱凤平⁴, 张弩⁵, 何科君⁶, 康德智⁷, 吴赞艺⁷, 贾旺¹^,*()

1. 100070 首都医科大学附属北京天坛医院神经外科学中心
2. 130033 长春, 吉林大学中日联谊医院神经外科
3. 450052 郑州大学第一附属医院神经外科
4. 200040 上海, 复旦大学附属华山医院神经外科
5. 510080 广州, 广东省人民医院(广东省医学科学院)神经外科
6. 510080 广州, 中山大学附属第一医院神经外科
7. 350005 福州, 福建医科大学附属第一医院神经外科

通讯作者: 贾旺
基金资助:
国家重点研发计划项目(2022YFC2405300); 国家重点研发计划项目(2022YFC2405301); 北京市自然科学基金-大兴创新联合基金资助项目(L246050); 北京市自然科学基金-大兴创新联合基金资助项目(L256057)

Abstract

Abstract:

Objective: To investigate efficacy, safety and outcomes of magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) for the treatment of brain metastases. Methods: From January 2022 to August 2024, 98 brain metastases patients underwent robot-assisted MRgLITT at 7 neurosurgical centers across the country were included. The effective rate of ablation was calculated based on tumor volume and ablation range to assess whether effective ablation was achieved; Karnofsky Performance Status (KPS) was used to evaluate functional status at preoperative, one, 3 and 6months after surgery. Kaplan-Meier survival curves were drawn to calculate the survival time. Results: A total of 130 intracranial lesions were found in the 98 patients, with a mean volume of (3.55±3.48)cm³ and the mean ablation volume of (6.65±5.48)cm³. Postoperative assessment showed that 92 patients (93.88%) achieved successful ablation with mean ablation rate was (94.15±10.26)%. The KPS score at one, 3, and 6months after surgery were 86.99±12.49, 85.11±17.09, and 82.24±18.32, respectively. The median overall survival was 15.81 (8.53, 23.82) months, and the one-year survival rate was 63.85%. Total 4 patients (4.08%) experienced postoperative complications. Conclusions: MRgLITT is a safe and effective procedure for treating brain metastases and can provide a new option for the systemic treatment. MRgLITT can achieve a favorable outcome comparable to surgical treatment, and its minimally invasive and safe characteristics make it worthy further application.

Key words: Metastasectomy, Surgery, computer-assisted, Neuronavigation, Kaplan-Meier estimate, Prognosis

摘要：

目的: 评价磁共振引导下激光间质热疗（MRgLITT）治疗脑转移瘤的有效性、安全性及预后。方法: 纳入2022年1月至2024年8月来自全国7所神经外科诊疗中心机器人辅助MRgLITT治疗的98例脑转移瘤患者，根据肿瘤体积与消融范围计算消融有效率，Karnofsky功能状态评分（KPS）评估术前及术后1、3和6个月功能状态，绘制Kaplan-Meier生存曲线计算生存期。结果: 98例患者共130个病灶行MRgLITT治疗，肿瘤平均体积（3.55±3.48）cm³，平均消融体积（6.65±5.48）cm³，平均消融率（94.15±10.26）%，其中92例（93.88%）患者消融有效（消融率 > 90%）。术前[（86.63±10.54）分]、术后1个月[（86.99±12.49）分]、3个月[（85.11±17.09）分]和6个月[（82.24±18.32）分]KPS评分差异无统计学意义；中位生存期15.81（8.53，23.82）个月，术后1年累积生存率63.85%；并发症发生率4.08%（4/98）。结论: MRgLITT治疗脑转移瘤安全、有效，患者预后与传统开颅手术相当，不仅为脑转移瘤的系统化治疗提供了新的选择，而且其微侵袭特性值得临床推广。

关键词: 转移瘤切除术, 外科手术，计算机辅助, 神经导航, Kaplan-Meiers评估, 预后

CLC Number:

R741

Zhan XUE, Xiu-dong GUAN, Yu-fei GAO, Jin-nan ZHANG, Dong-ming YAN, Yu-chen JI, Jin-song WU, Feng-ping ZHU, Nu ZHANG, Ke-jun HE, De-zhi KANG, Zan-yi WU, Wang JIA. Clinical characteristics and prognosis of magnetic resonance-guided laser interstitial thermal therapy for brain metastases[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2026, 26(8): 896-902.

薛湛, 管修东, 高宇飞, 张金男, 闫东明, 季玉陈, 吴劲松, 朱凤平, 张弩, 何科君, 康德智, 吴赞艺, 贾旺. 脑转移瘤磁共振引导下激光间质热疗临床特点与预后研究[J]. 中国现代神经疾病杂志, 2026, 26(8): 896-902.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2026.08.013

https://journal11.magtechjournal.com/cjcnn/EN/Y2026/V26/I8/896

Figures/Tables 3

Figure 1 MRI findings Preoperative axial thin-slices 3D enhanced T₁WI showed the tumor located in the left centrum semiovale (arrow indicates, Panel 1a). Two optical fiber paths were used and the ablation range was estimated (Panel 1b). The surgery was performed under the guidance of the robot (Panel 1c). Transfer to MR room for ablation procedure (Panel 1d). Axial GRE monitor to performed ablation (color bands represent different temperatures during the ablation process, the higher the temperature, the more vibrant the color; Panel 1e). Postoperative axial thin-slices 3D enhanced T₁WI showed optical fiber path within lesion, round enhancement was observed and lesion internal signal in uniformed, indicating the ablation was satisfactory (Panel 1f).

Table 1. ANOVA of single-factor repeated measures for scores in patients with brain metastases before and after MRgLITT

变异来源	SS	df	MS	F值	P值
测量时间	1437.661	3	479.223	2.498	0.061
个体间误差	15476.957	76	203.646
个体内误差	43837.340	228	192.274
总变异	60751.955	307	195.344

Figure 2 Overall survival of patients with brain metastases treated by MRgLITT.

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